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Prostate CancerPhase 1/2NCT00503984

A Phase I/II Study of Azacitidine, Docetaxel, and Prednisone for Metastatic Prostate Cancer Patients

A Phase 1/2 study testing Azacitidine, Docetaxel and Prednisone in people with Prostate Cancer and Pain, run by University of Miami at 1 site in United States.

Terminated

Stopped early. The study ended before it was planned to and will not resume.

Official record
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Trial summary

Azacitidine can reverse clinical resistance to docetaxel through upregulation of Growth Arrest and DNA Damage inducible alpha (GADD45α) and other epigenetically regulated genes. Read more about this study

Who is it for?
Ages 18 to 120 years, men only
Conditions the study is for
Prostate Cancer, Pain
What is being tested?
Azacitidine, Docetaxel and Prednisone
Type of treatment
Injection or infusion
Could I receive a placebo?
No, everyone receives an active treatment
How many people
22 participants
Where
1 siteUnited States
Study dates
May 2007to Jun 2015
Phase
Phase 1/2
Are there results?
Yes, posted in the registrySummary in the doctors' view

Key requirements

Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.

  • Ages 18 to 120 years
  • Men only
  • No healthy volunteers
  • Adult, Older adult

Who may be able to join

  • Patient who had histologically confirmed adenocarcinoma of the prostate.
  • Patient must have radiologically documented metastatic disease.
  • Patients should have received at least 12 weeks of docetaxel chemotherapy or a cumulative docetaxel dose of 300 mg/m2 and have disease progression on docetaxel-based therapy. Patients must have progressed after prior hormonal therapy (e.g. medical or surgical castration) as defined by a castrate level of testosterone (less than 50 ng/mL). If patient underwent medical castration, it must be continued during the study.
  • Progressive disease may be documented by:
  • Non-measurable disease:
  • Serum PSA progression defined as a rise in at least 2 consecutive serum PSA values, each obtained at least 1 week apart and an absolute value greater than 2.0 ng/ml or,
Show all 27Show fewer
  • Appearance of two or more new lesions on bone scan.
  • Patients with treated epidural lesions and no other epidural progression will be eligible.
  • Measurable disease
  • Documented progression of disease by Response Evaluation Criteria In Solid Tumors (RECIST) criteria demonstrating at least one visceral or soft tissue metastatic lesion (including new lesion).
  • Nodal or visceral progression will be sufficient for trial entry independent of PSA
  • Only lymph nodes ≥ 2 cm in diameter will be used to assess for a change in size.
  • Previously irradiated lesions, primary prostatic lesion, and bone lesions will be considered non-measurable disease.
  • Patient is 18 years or older.
  • Patient had a Karnofsky Performance Status (KPS) of at least 70% or Eastern Cooperative Oncology Group (ECOG) Performance Status score of 0-2.
  • Life expectancy of > 6 months.
  • Patient with adequate organ function as defined as
  • Absolute Neutrophils Count greater than 1500 cells/mm3
  • Platelets greater than 100,000 cells/mm3
  • Hemoglobin greater than 8 g/dL,
  • Adequate liver function as documented by:
  • Total Bilirubin </= 1.5 times the upper limit of the normal range for the laboratory (ULN). Higher levels are acceptable if these can be attributed to active hemolysis or ineffective erythropoiesis.
  • AST and ALT </= 2.5 ULN. (In determining eligibility the more abnormal of the two values (AST or ALT) should be used.)
  • Serum creatinine </= 2.0 mg/dl or </= 1.5 x institutional upper limit of normal.
  • Male patient must be willing to use an acceptable barrier method for contraception; and must agree not to father a child whilst receiving treatment with Azacitidine and up to six months after last dose.
  • Patients may have a history of prior malignancy (≥ 5 years prior) provided that the patient is currently disease free and off all therapy for that malignancy. Patients with non-melanoma skin cancer or carcinoma in situ of any type are not excluded if they have undergone complete resection.
  • Patients must be informed of the investigational nature of the treatment and must give signed written and informed consent.

Who cannot join

  • Patients who have received strontium 89 (metastron®), Samarium 153 (quadramet®) radiation therapy within 8 weeks of enrollment.
  • Evidence of significant active infection during screening for eligibility.
  • Patients who have had a psychiatric illness that could potentially interfere with completion of treatment according to protocol.
  • Patients who had chemotherapy or radiotherapy within 4 weeks prior to entering the study or those who have not recovered from adverse events due to agents administered more than 4 weeks earlier. There is no wash-out period for patients who received Zytiga.
  • Patient who had brain metastases.
  • Patient who had history of allergic reactions attributed to compound or similar chemical or biological composition to azacitidine (Vidaza®) or docetaxel or other drugs formulated with polysorbate 80 or mannitol.
  • Patient had major surgical procedure within 28 days before Day 1 of treatment.
  • Hepatic malignancy.

Trial locations and contacts

1 site in 1 country.

United States1 site
  • University of Miami Sylvester Comprehensive Cancer Center

    Miami, Florida, 33136

Other trials in United States

About this study

Official title: A Phase I/II Study of Azacitidine (Vidaza), Docetaxel and Prednisone for Patients With Hormone Refractory Metastatic Prostate Cancer Previously Treated With a Taxotere Containing Regimen.

Azacitidine can reverse clinical resistance to docetaxel through upregulation of Growth Arrest and DNA Damage inducible alpha (GADD45α) and other epigenetically regulated genes.

Read the detailed description

Study design A phase I/II clinical trial in patients with hormone refractory metastatic prostate cancer.

Primary objective phase I component of study:

To determine a safe and potentially efficacious phase II dose of azacitidine in combination with docetaxel and prednisone that can be used for the treatment of hormone refractory metastatic prostate cancer.

Primary objective phase II component of study:

To determine the therapeutic efficacy of combined therapy of azacitidine, docetaxel, and prednisone, in the treatment of hormone refractory metastatic prostate cancer. The primary measure of therapeutic efficacy is response, defined as prostate-specific antigen (PSA) response, complete response (CR), or partial response (PR).

Secondary endpoints are toxicity, duration of response, progression-free survival, and overall survival.

Being tested
Azacitidine, Docetaxel, Prednisone, GADD45α methylation and expression analysis, Pegfilgrastim
Keywords
Adenocarcinoma of the prostate, Recurrent prostate cancer, Stage IV prostate cancer, Pain
Medical subject headings
Prostatic Neoplasms, Pain

What participants receive

What participants receive. In a randomised study each person is assigned to one group by chance.

  • AzacitidineDrug

    Also called Vidaza®

    Intravenous infusion over 30 minutes Days 1 - 5 of each 3 weekly cycle.

  • DocetaxelDrug

    Also called Taxotere®

    Intravenous infusion over 1 hour on day 6 of each 3 weekly cycle.

  • PrednisoneDrug

    Patient will receive prednisone 5mg twice a day from Day 1 to 21 of each cycle.

  • GADD45α methylation and expression analysisGenetic

    Peripheral blood samples from patients will be collected as described in section 8.1 (total of 4 blood samples). DNA will be isolated from serum, bisulfite treated and evaluated for methylation by bisulfite genomic sequencing.

    Patients with accessible prostate tissue or metastases will undergo biopsy prior to treatment if they consent to do so.

  • PegfilgrastimDrug

    Also called Neulasta

    Growth factor support.Granulocyte-colony stimulating factor (G-CSF)

  • FilgrastimDrug

    Also called Neupogen

    Growth factor support. Granulocyte-colony stimulating factor (G-CSF)

Study groups in NCT00503984
Study groupRoleWhat they receive
Phase 1 - Aza + DocExperimentalPhase 1 Azacitidine (Aza) and Docetaxel (Doc) with dose escalation/de-escalation design, and Prednisone, with growth factor support; GADD45α methylation and expression analysis, with optional growth factor support (pegfilgrastim/filgrastim).
Receives: Drug: Azacitidine; Drug: Docetaxel; Drug: Prednisone; Genetic: GADD45α methylation and expression analysis; Drug: Pegfilgrastim; Drug: Filgrastim
Phase 2 - Aza + Doc RPTDExperimentalRecommended Phase Two Dose (RPTD) of Azacitidine and Docetaxel; and Prednisone; with optional growth factor support (pegfilgrastim/filgrastim).
Receives: Drug: Azacitidine; Drug: Docetaxel; Drug: Prednisone; Drug: Pegfilgrastim; Drug: Filgrastim

What is being measured

The primary outcome is the main question the study is designed to answer.

  1. Phase I - Recommended Phase Two Dose (RPTD) of Azacitidine and Docetaxel in Combination With Prednisone. (Azacitidine and Docetaxel)

    Determination of a safe and potentially efficacious phase II dose of azacitidine in combination with docetaxel and prednisone that can be used for the treatment of hormone refractory metastatic prostate cancer.

    Measured: Up to 1.5 years

  2. Phase I - Recommended Phase Two Dose (RPTD) of Azacitidine and Docetaxel in Combination With Prednisone. (Prednisone)

    Determination of a safe and potentially efficacious phase II dose of azacitidine in combination with docetaxel and prednisone that can be used for the treatment of hormone refractory metastatic prostate cancer.

    Measured: Up to 1.5 years

  3. Number of Participants Achieving Prostate-specific Antigen (PSA) Response.

    Number of participants achieving prostate-specific antigen (PSA) response according to Prostate Cancer Working Group 1 (PCWG1) criteria. PSA response according to PCWG1 is defined as an least 50 percent decline in PSA level from baseline that was maintained for at least three weeks.

    Measured: Up to 4.5 years.

  4. Number of Participants Achieving Complete Response (CR) or Partial Response (CR) to Protocol Therapy.

    Number of participants achieving Complete Response (CR) or Partial Response to protocol therapy according to Response Evaluation Criteria In Solid Tumors (RECIST) 1.0 Criteria. Per RECIST 1.0 for target lesions and assessed by MRI: "Complete Response (CR), Disappearance of all target lesions; Partial Response (PR), >=30% decrease in the sum of the longest diameter of target lesions; "

    Measured: Up to 4.5 years

Secondary outcomes (4)
  1. Duration of Response

    Length of time from the date of first observation of complete response (CR) or partial response (PR) to the date of first observation of disease progression, according to prostate-specific antigen (PSA) response according to Prostate Cancer Working Group 1 (PCWG1) criteria. PSA response according to PCWG1 is defined as an least 50 percent decline in PSA level from baseline that was maintained for at least three weeks.

    Measured: Up to 4.5 years.

  2. Progression-Free Survival (PFS)

    The time from the date of start of treatment until the first documented or confirmed disease progression, or death related to prostate cancer, whichever is earlier.

    Measured: Up to 4.5 years

  3. Overall Survival (OS)

    The time from the date of initiation of study treatment until date of death from any cause.

    Measured: Up to 4.5 years.

  4. Number of Participants Experiencing Adverse Events After Beginning Protocol Therapy.

    Measured: Up to 4.5 years

Timeline

From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.

  1. First posted19 Jul 2007 (estimated)
  2. Study startMay 2007
  3. Primary completionJun 2015
  4. Study completionJun 2015

Why it stopped: Withdrawal of Funding

Resources

More details

For doctors and researchers: how the study is designed, who runs it, and its registry IDs.

Study design
Study type
Interventional
Phase
Phase 1/2
Primary purpose
Treatment
Allocation
Non-randomised
Intervention model
Single group
Masking
None (open label)
Enrolment
22 participants (actual)
IDs, dates and publications
ClinicalTrials.gov ID
NCT00503984
Sponsor's protocol ID
20061143
Other IDs
SCCC-2006080, WIRB-20070344, 20140376
Status last verified
May 2016
First submitted
17 Jul 2007
Last updated
9 Jun 2016
Data monitoring committee
Yes

Publications

  • Singal R, Ramachandran K, Gordian E, Quintero C, Zhao W, Reis IM. Phase I/II study of azacitidine, docetaxel, and prednisone in patients with metastatic castration-resistant prostate cancer previously treated with docetaxel-based therapy. Clin Genitourin Cancer. 2015 Feb;13(1):22-31. doi: 10.1016/j.clgc.2014.07.008. Epub 2014 Aug 1.

    PubMed 25178642

Questions about this trial

What is this clinical trial studying?

A Phase 1/2 study testing Azacitidine, Docetaxel and Prednisone in people with Prostate Cancer and Pain, run by University of Miami at 1 site in United States.

The full registered description is in the About this study section and the official record.

Who may be eligible to take part?

The sponsor lists 27 inclusion and 8 exclusion criteria. Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.

Is this clinical trial currently recruiting?

The record says: stopped early, as of the sponsor's last update on 9 Jun 2016. Status can change between updates, so confirm with the study contact before making plans.

Where is the study taking place?

The record lists 1 site in United States. Whether a site is taking part right now should be confirmed with that site. See every site.

What are the possible benefits and risks?

They depend on the study and the treatment, and no study can promise a benefit. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.

What does this combined phase mean?

Phase 1 studies test a treatment in a small group of people for the first time or in a new way, mainly to check safety and find the right dose.

Phase 2 studies give the treatment to a larger group to see whether it has the intended effect and to keep checking safety.

Not every study follows the same path, and some studies (observational studies, device studies) have no phase.

Are results available for this study?

Yes. Results are posted in the registry (first posted 20 Jan 2016). A summary is in the For doctors view, and the full results are on ClinicalTrials.gov.

How can a doctor refer a patient or contact the research team?

The record lists no contact. The official record names the sponsor, who can be asked directly. AzTrials does not enrol participants or take referrals.

What does the primary outcome measure?

Phase I - Recommended Phase Two Dose (RPTD) of Azacitidine and Docetaxel in Combination With Prednisone. (Azacitidine and Docetaxel) (time frame: Up to 1.5 years). The study lists 4 primary outcomes in all. It is what the study was designed to measure, not a finding.

Where can I read the original study information?

On the ClinicalTrials.gov record for NCT00503984, which also lists 1 linked publication.

Does a listing mean the treatment is approved or proven to work?

No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.

How often is this information updated?

AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 9 Jun 2016.

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